Complementary And Alternative Medicine Therapies Research Articles

Potential application of herbal medicine treatment based on pattern identification for canine cognitive dysfunctional syndrome: a comparative analysis of Korea medicine therapy for patients with dementia

Canine cognitive dysfunction syndrome (CDS) is a neurodegenerative disease that causes cognitive and behavioral disorders and reduces the quality of life in dogs and their guardians. This study reviewed the complementary and alternative medicine (CAM) for CDS and compared the diagnosis and therapy of CAM between CDS in canines and dementia in humans. The evaluation tools for the diagnosis of CDS and dementia were similar in the neurological and neuropsychiatric examinations, daily life activity, cognitive tests, and neuroimaging, but the evaluation for dementia was further subdivided. In CAM, pattern identification is a diagnostic method for accurate, personalized treatment, such as herbal medicine. For herbal medicine treatment of cognitive impairment in canines and humans, a similar pattern identification classified as deficiency (Qi, blood, and Yin) and Excess (phlegm, Qi stagnation, and blood stasis) is being used. However, the veterinary clinical basis for verifying the efficacy and safety of CAM therapies for CDS is limited. Therefore, based on CAM evidence in dementia, it is necessary to establish CDS-targeted CAM diagnostic methods and therapeutic techniques considering the anatomical, physiological, and pathological characteristics of dogs.

Complementary and alternative medicine for treating epilepsy in China: A systematic review

There are about 10 million people with epilepsy (PWE) in China. In addition to therapies approved by the National Medical Products Administration, the use of complementary and alternative medicine (CAM) is prevalent in Chines PWE. These CAM therapies mainly comprise traditional Chinese medicine herbs (TCMHs), acupuncture, and music. A retrospective literature search was performed to summarize the updates of CAM in China in the past ten years, and sixty-two papers were finally included. In this following review, we listed the animal and clinical studies to summarize the antiepileptic mechanisms and clinical efficacy of CAM in Chines PWE. The main mechanisms of TCMHs and acupuncture included regulation of neurotransmitters and receptors, voltage-gated ion channels modulation, expression of apoptosis-related genes, antioxidant response, and anti-inflammation. Although there were enormous clinical studies on them, the current available clinical trials were small, short-term, heterogeneous, and had a high risk of bias. With regard to music, a few studies conducted by Chinese scholars suggested that it was beneficial for PWE as an add-on therapy, which was consistent with the results of foreign studies. Further randomized clinical trials in large populations are required to prove the effectiveness and safety of CAM.

The Treatment of Complementary and Alternative Medicine on Female Infertility Caused by Endometrial Factors.

Recently, with the development of the social economy, the incidence of infertility has increased year by year. With its complex etiology and diversified syndromes, infertility has become one of the most important diseases that plague the physical and mental health of women of childbearing age worldwide. Endometrial factors as an important part affecting female reproductive capacity, due to which induced repeated abortion and multiple uterine cavity operations occur, can destruct endometrium, failing to provide a normal implantation environment for zygote, thus resulting in infertility. Many patients failed to achieve expected results after receiving conventional treatments such as hormone therapy, assisted reproductive technology (ART), granulocyte colony-stimulating factor (G-CSF) therapy, and cell therapy, then turn to complementary and alternative medicine (CAM) therapies for help. Aiming at clarifying the effectiveness and mechanisms of CAM therapy in the treatment of infertility caused by endometrial factors, our paper systematically searched and studied present related literature on the PubMed, CNKI, and other databases, focusing on the aspects of clinical application and mechanism explorations and highlighting the therapeutic effects of Chinese herbal medicine (CHM), acupuncture, and moxibustion on such diseases. Moreover, this paper also introduces the CAM treatments of traditional Chinese medicine (TCM) retention enema, neuromuscular electrical stimulation (NMES), photobiomodulation therapy, dietary intervention, and other measures for infertility caused by endometrial factors, in order to provide a reference for subsequent basic research and clinical work.

Survey of Lifestyle, Past Medical History and Complementary and Alternative Medicine Use Among Adult Patients Participating in the National Cancer Institute's Exceptional Responders Initiative

IntroductionThe Exceptional Responders Initiative (ERI) at the National Cancer Institute attempts to correlate unusually good outcomes in patients with cancer with genetic targets in tumors and the therapies the patients received. It is not known if other factors might contribute to exceptional responses or outcomes. We explored aspects of the medical history, lifestyle changes, complementary and alternative medicine (CAM) use and communication between health care practitioners and patients who experienced an exceptional response following cancer treatment. MethodsAll subjects whose case was submitted to the ERI were eligible to participate in the survey. A 121-question survey questionnaire was developed to assess aspects of the subject's past medical history, lifestyle (e.g., diet, exercise, spirituality) and use of CAM. ResultsThirty subjects completed and returned the questionnaire from approximately 88 patients invited to participate (approximate response rate = 34%). Approximately 68% were female and 32% were male. Fifty percent of subjects changed their diet after their cancer diagnosis. Eighteen patients (60%) reported using a CAM therapy (not including oral vitamins/minerals or spiritual practices) during their Exceptional Response (ER). ConclusionMultiple factors, including features of the tumor itself, the patient, or the environment, could affect tumor response or patient survival, either solely or in combination with the treatments received. Many patients use other medications, change their diet or physical activity or use CAM interventions after their cancer diagnosis. Investigators attempting to understand the exceptional response phenomenon should acquire rich data sets of their subjects that include information about these factors.

A triangulated perspective for understanding CAM use in Lebanon: a qualitative study

BackgroundExisting evidence marked a prevalent use of Complementary and Alternative Medicine (CAM) therapies in Lebanon that is concomitant with low rates of disclosure to health care providers and limited knowledge among the general public of safety and side effects of CAM use.ObjectivesTo examine the perspectives of Lebanese CAM users, CAM providers, and health care providers (HCPs) regarding their understanding of CAM and of the Push and Pull factors that drive its use.MethodsA qualitative research study was conducted using in-depth interviews, targeting Lebanese adults (CAM users; 18-65 years) (n=14), CAM providers such as yoga instructors, owners of CAM product outlets, herbalists, and religious figures (n=13); and HCPs including physicians, nurses, dietitians, and pharmacists (n=14). The topic guide covered, in addition to the understanding of CAM, the Push and Pull factors driving CAM use. The adults were recruited by convenient sampling, and CAM providers and HCPs using a purposive sampling approach. Interviews were audiotaped, transcribed, and translated into English. Analysis was performed using a qualitative thematic approach. Similarities and differences in the perceptions of the participants with regards to factors that influence CAM use were charted and contrasted, using a triangulated approach.ResultsThe three study groups exhibited a similar understanding of CAM, referring to non-conventional therapies used to prevent/treat diseases or to enhance wellbeing. CAM users and CAM providers identified “distrust in HCPs”, “lack of patient-centered care in CM”, and “limitations and side effects of CM” as important Push factors. All study groups highlighted the limited CAM knowledge of HCPs as a main reason for the lack of patient-centered care. All three groups also underscored the affordability and the social and cultural support for CAM as main enablers of its prevalent use. Unlike HCPs who were skeptical about the safety and effectiveness of CAM, CAM users and CAM providers indicated that most of CAM therapies are safe and efficient.ConclusionsThe triangulation of perspectives (CAM users, CAM providers, and HCPs) in this study allowed a comprehensive appraisal of CAM use and its drivers. Improving the HCPs’ CAM-related knowledge, promoting patient-centered care and fostering an open dialogue between HCPs and CAM providers are among the recommendations of the study.

Complementary and alternative medicine use among adults with eczema: A population-based study

To the Editor: Atopic dermatitis (AD), or eczema, is a chronic, inflammatory skin disease affecting 10.2% of adults in the United States.1 Some patients with AD use complementary and alternative medicine (CAM) for the adjuvant treatment of their disease.2 Although many studies have demonstrated a promising role of certain CAM modalities in the management of AD, others have shown limited efficacy and negative side effects of various CAM therapies.3 Given the inconclusive evidence for the efficacy of various CAM therapies, it is important to determine the extent of CAM use among adults with AD.

Regardless of the Source of Products, Pharmacists Must Be a Source for Trustworthy Advice.

Complementary and alternative medicines (CAMs) present a range of unique challenges for health care practitioners, including pharmacists who provide care for older people. Albeit many pharmacists receive little or no training that would provide them with an insight into the nature of CAMs, CAM products are widely embraced by American consumers, with 42% of people in the United States reporting that they have used at least one CAM therapy, but in less than 40% of cases is the use of these products disclosed to a physician.

Complementary and Alternative Medicine Use by ADHD Patients: A Systematic Review

Objective: This study aimed to review the prevalence of complementary and alternative medicine (CAM) use and its different used types, characteristics of the studied cohorts, the reasoning for CAM use, and possible predictive factors for its use amongst ADHD patients. Method: The Web of Science Core Collection, PubMed, and Scopus were searched from inception to 10 February 2022. All of the original papers published in English which report data on CAM use by patients with ADHD were included. Results: Twelve original researches including 4,447 patients were included. The prevalence of CAM use varied from 7.5% to 67.6%. The most-reported CAM modalities were dietary modifications and natural products. Moreover, higher parental education should be considered as a predictive factor for CAM use. Conclusion: CAM use by ADHD patients seems to be prevalent. Healthcare providers should be trained about the most commonly used CAM therapies and their possible adverse events.

Neck pain clinical practice guidelines: a systematic review of the quality and quantity of complementary and alternative medicine recommendations.

Individuals with neck pain frequently turn to complementary and alternative medicine (CAM) to seek relief. However, conventional healthcare providers often lack adequate CAM therapy knowledge to deliver informed recommendations to patients. The purpose of this study was to identify mention of CAM in neck pain clinical practice guidelines (CPG) and assess the quality of CAM recommendations using the Appraisal of Guidelines for Research & Evaluation II (AGREE II) instrument. MEDLINE, EMBASE and CINAHL were systematically searched from 2009 to 2020 in addition to the Guidelines International Network and National Center for Complementary and Integrative Health websites. Eligible CPGs providing CAM recommendations were assessed twicewith the AGREE II instrument, onceto assess the overall CPG and then onceto assess the CAM sections specifically. From 643 unique search results, 15 CPGs on the treatment and/or management of neck pain were identified, and 8 made recommendations on CAM therapy. Regarding scaled domain percentages, the overall CPG scored higher than the CAM section for 5 of 6 domains (overall, CAM): (1) scope and purpose (93.4%, 93.1%), (2) stakeholder involvement (81.6%, 81.9%), (3) rigour of development (70.8%, 66.3%), (4) clarity of presentation (64.9%, 60.8%), (5) applicability (39.3%, 33.6%), and (6) editorial independence (47.9%, 45.3%). Most neck pain CPGs made CAM recommendations. The quality of CAM recommendations is lower than overall recommendations across all domains with the exception of stakeholder involvement. This disparity highlights the need for CAM recommendations quality improvement. Although many patients with neck pain seek CAM therapies, few CPGs are available for healthcare providers and patients.

Complementary and alternative medicines (CAM) for attention-deficit / hyperactivity disorder (ADHD) in children

ADHD is one of the most common neurodevelopmental disorders in children that persist into adulthood. Commonly used medications, like stimulants, have serious side effects and short-lived effects, which limit their usage to a small group of children. This predicament leaves room for the exploration of various Complementary Alternative Medicines (CAM) and their efficacy in the place of pharmacological treatment or as an add-on treatment to reduce the dosage of stimulant medication. The absence of side effects draws parents to CAM. Some of the standard CAM therapies discussed in this article are dietary changes, behavioral changes, academic or school-based interventions, homeopathy, Traditional Chinese Medicine, Chinese Herbal Medicine, Cognitive training, Cognitive Behavior Therapy, Neurofeedback, Meditation, and yoga. Though the efficacy of the non-pharmacological treatments is still conflicting, parents continue to try out these Complementary and Alternative Medicines and Therapies and report improvements in ADHD symptoms and behavioral and academic gains.

Ojeok-san ameliorates visceral and somatic nociception in a mouse model of colitis induced colorectal cancer.

Cancer patients can develop visceral, somatic, and neuropathic pain, largely due to the malignancy itself and its treatments. Often cancer patients and survivors turn to the use of complementary and alternative medicine (CAM) to alleviate pain and fatigue. Thus, it is necessary to investigate how CAM therapies work as novel analgesics to treat cancer pain. Ojeok-san (OJS) is an herbal formula consisting of seventeen herbs. This herbal formula has been shown to possess anti-inflammatory, immunoregulatory, and analgesic properties. In this study, we examined the potential beneficial effects and mechanism of action of OJS in a preclinical model of colitis-associated colorectal cancer. Male and female C57BL/6J mice were exposed to the carcinogen, azoxymethane (AOM, 10 mg/kg) and a chemical inflammatory driver, dextran sulfate sodium (DSS1-2%), to promote tumorigenesis in the colorectum. OJS was given orally (500, 1000, and 2000 mg/kg) to determine its influence on disease activity, tumor burden, nociception, sedation, Erk signaling, and behavioral and metabolic outcomes. In addition, in vitro studies were performed to assess CT-26 cell viability, dorsal root ganglia (DRG) activation, and bone-marrow-derived macrophage (BMDM) inflammatory response to lipopolysaccharide stimulation after OJS treatment. We found that administration of 2000 mg/kg of OJS was able to mitigate mechanical somatic and visceral nociception via Erk signaling without affecting symptom score and polyp number. Moreover, we discovered that OJS has sedative properties and elicits prolonged total sleeping time in AOM/DSS mice. Our in vitro experiments showed that OJS has the capacity to reduce TNFα gene expression in LPS-stimulated BMDM, but no changes were observed in DRG spike number and CT-26 cell proliferation. Taken together, these data suggest that OJS ameliorates nociception in mice and warrants further examination as a potential CAM therapy to promote analgesia.

Herbal medicine as a first-line choice of complementary medicine for South Indian parents/caregivers in the management of ASD children

BackgroundParents/caregivers of children with Autism Spectrum Disorder (ASD) try different approaches to manage their child’s condition, of which one of the popular approaches is using Complementary and Alternative Medicine (CAM) treatment. ObjectivesThe present study aimed to estimate the prevalence and describe the pattern of CAM usage in a tertiary care South Indian hospital. MethodsA cross-sectional study was conducted among the parents/caregivers of children with ASD to specifically report the usage of CAM in their children. Data was also collected about the type of CAM, source, reasons, expectations, effectiveness, harmful effects, and the treating pediatrician’s opinion on CAM usage. ResultsA total of 257 parents/caregivers of children with ASD participated in the study. 24.5% of the children were exposed to at least one CAM therapy. The most commonly given CAM therapy was herbal medicine (71.4%). Parents/caregivers tried CAM therapy as their children’s core symptoms of ASD did not show much improvement with the existing therapy (80.9%). They expected that CAM therapy would at least control the progression of the disability (61.9%). CAM usage did not produce any adverse effects (100%). The baseline characteristics between the CAM users and non-users were similar expect for gender, which showed a statistically significant difference (p = 0.008). About 55.5% of the parents/caregivers did not discuss the usage of CAM for their child with their treating pediatrician. ConclusionHerbal medicines are frequently given CAM to children with ASD in India. History of CAM therapy usage should be a part of the medication history interview.

Safety and efficacy of siddha medicine preparation in the management of COVID-19: A prospective randomised open label study

BackgroundThe use of complementary and alternative medicine (CAM) therapies has surged since the spread of COVID-19 pandemic. However, the efficacy and safety of these CAM therapies remains majorly unexplored. ObjectiveTo understand the efficacy and safety of Nochi Kudineer Chooranam (5 gm), Mahasudarsan Chooranam (3 gm) , Adathodai Manapagu (10 ml), Omatheeneer (10 ml), Maldevi chenduram (100 mg) with honey in management of COVID 19 patients. MethodsWe conducted a randomised, controlled, open label trial in patients hospitalized with SARS-CoV-2 infection who had an oxygen saturation of 90% or more while breathing ambient air. Patients were randomized into two groups in a 1:1 ratio to either intervention group, receiving seven days of siddha medicine (Intervention group; n = 50) or standard care (control group; n = 50). The primary end point was clinical markers and patient recovery status on day 8. ResultsA total of 100 patients with confirmed COVID-19 with average age of 37 yrs (interquartile range, 28–49) participated in the study. There was no statistically difference between groups at baseline (P > 0.05). After intervention, patients in the intervention group had statistically (P < 0.05) significant reduction in the symptoms when compared to standard care. By end of the intervention period, 6 patients (12%) were hospitalized in the control group and none of them were reported for intervention group. ConclusionAmong patients with mild to moderate COVID-19, 7 days of siddha medicine showed a significant reduction in the clinical symptoms and requirement of hospitalisation, with no adverse events. Therefore, the particular siddha medicine preparation could be used safely and effectively for the management of COVID-19 patients.

Complementary and alternative medicine exposure in oncology (CAMEO) study: A multi-institutional cross-sectional analysis of patients receiving cancer treatment.

e18739 Background: Compared to standard of care treatments, complementary and alternative medicine (CAM) use has been associated with decreased survival in cancer patients. CAM includes a broad range of treatments including vitamins/minerals, herbs/supplements, special diets, and mind/body interventions. An improved understanding of contemporary prevalence, predictors and intended goals of CAM use is needed to improve the cancer patient experience and guide shared decision-making regarding risks and benefits of their use. Methods: A cross-sectional survey of prospectively enrolled adult cancer patients treated at a large regional non-profit cancer center and an NCI-Designated Comprehensive Cancer Center between 2020 and 2021 was collected. Patients receiving cancer treatment were selected for analysis and grouped based on reported CAM use. Differences between CAM users and nonusers were assessed by chi-squared for categorical and two-sample t-test for continuous variables. Predictors of CAM use were identified with univariable and multivariable logistic regression. Results: Of 749 respondents, 83.31% had heard of or been recommended a CAM. Rates of CAM use during cancer treatment were highest for vitamins/minerals (56%), mind/body (52%), herbs/supplements (38%), special diets (30%), and other (12%). In the most common primary cancers, overall rates of CAM use were high (Breast: 84%, prostate: 66%, lung: 79%). Most patients (91%) use CAM in addition to conventional treatments. The intended goal of CAM therapy was most often management of symptoms (42%), treatment of cancer (30%), and mental health (15%). CAM users were younger than non-users (median age 62 years [y] vs 65y, p = 0.03). Females had higher rates of CAM use compared to males (86% vs. 78%, p &lt; 0.01). Patients with incurable cancer had higher rates of CAM use than those with curable cancer (82% vs. 72%, p &lt; 0.01). Predictors of CAM use on multivariable model include female gender (OR 2.5, p &lt; 0.01) and incurable cancer (OR 2.5, p &lt; 0.01). During cancer treatment, patients using CAM used multiple therapies and therapy types, including an average of 3.3 vitamins/minerals, 3.1 herbs/supplements, 2.5 mind/body exercises, and 1.6 special diets. Conclusions: CAM use is common among cancer patients receiving radiation, chemotherapy, and or surgery. Many patients are taking multiple CAM therapies during treatment with one third of patients using CAM with the intended goal of treating their cancer. This data provides details about and predictors of CAM use and provides information to guide patient-physician discussions.

Shifting perceptions of alternative therapies in cancer patients during the COVID-19 pandemic: Results from the Complementary and Alternative Medicine Exposure in Oncology (CAMEO) Study.

e24130 Background: Complementary and alternative medicine (CAM) use has been associated with worse survival outcomes in cancer patients compared to standard of care therapies. CAM has received a significant increase in public awareness and interest in the COVID-19 pandemic era. We sought to understand how the COVID-19 pandemic affected CAM use and perceptions in cancer patients. Methods: Data was collected from adult cancer patients prospectively enrolled on a cross-sectional survey conducted at an NCI-designated cancer center and a comprehensive cancer center between 2020 and 2021. The survey included questions assessing changes in patient attitude towards CAM and likelihood of using CAM, both relative to prior to COVID-19. Analyzed CAM users included those taking vitamin, mineral and herbal supplements, alternative medicines and special diets, and excluded mind-body practices as the focus of this analysis was on enteral and parenteral CAM therapies. Differences in the impact of COVID-19 on CAM use beliefs and practices between CAM users and non-users were analyzed with χ2 and two-sample t-tests. Results: Out of 749 respondents, 578 (77%) used any CAM and 470 (63%) used enteral or parenteral CAM. Results shown in table. Compared to prior to COVID-19, CAM users were more likely to view CAM more favorably (12% vs 5%, p &lt; 0.01), while non-users were more likely to have an unchanged opinion (90% vs 84%, p = 0.03). Females had higher rates of viewing CAM more favorably than males (80% vs 58%, p = 0.04). Patients who viewed CAM more favorably had higher rates of self-reported incurable cancer (36% vs 11%, p = 0.04), declining recommended hormone therapy (22% vs 0%, p &lt; 0.01), and higher trust of social media (19% vs 0%, p = 0.02) and websites (24% vs 0%, p &lt; 0.01). Since the start of COVID-19, CAM users were more likely to report increased likelihood of using CAM (12% vs 6%, p = 0.01). Patients who were more likely to use CAM had higher rates of declining recommended chemotherapy (12% vs 0%, p = 0.02), and higher trust of social media (15% vs 2%, p = 0.01) and websites (28% vs 7%, p &lt; 0.01). Conclusions: During the COVID-19 pandemic, attitudes on CAM use in oncology patients have become increasingly polarizing. Patients with favorable attitudes toward CAM were likely to decline recommended standard of care therapy and more like to use CAM since COVID-19. This data helps characterize shifting attitudes toward CAM and may help guide shared decision-making between physician and patient.[Table: see text]

Complementary and Alternative Medicine in Crohn's Disease.

Complementary and alternative medicine (CAM) is a growing entity within inflammatory bowel disease (IBD). CAM includes mind-based therapies, body-based therapies, supplements, vitamins, and probiotics. Limitations currently exist for health care providers as it pertains to IBD and CAM that stem from knowledge gaps, conflicting reports, limited oversight, and a lack of well-organized clinical data. Even without well-described data, patients are turning to these forms of therapy at increasing rates. It is imperative that the ongoing review of CAM therapies is performed, and future trials are performed to better understand efficacy as well as adverse effects related to these therapies.

Use of Interpretative Phenomenological Analysis in Alternative Complementary Therapy Research

Complementary and alternative medicine (CAM) continues to increase globally in treating various diseases. However, the potential role of CAM in modern clinical practice and health care systems appears to be limited and often even questioned. This limitation is caused by a demand to evaluate the success of CAM with a biomedical approach measure. The biomedical discipline uses scientific objectivity to explain medical phenomena through evidence-based methods, and the same method is often not applicable to CAM phenomena. This article proposes a qualitative research method with an Interpretative Phenomenological Analysis (IPA) approach that is more suitable to assess the success of CAM with a focus on the healing or life experience of participants. The use of qualitative research methods with an IPA approach provides a powerful tool for addressing doubts about the efficacy of CAM. Evidence of efficacy obtained from the healing experience of patients captured by the IPA method can be defiance of the hegemony of conventional biomedical evidence construction. The use of IPA in research on CAM therapy provides a different perspective from the quantitative approach to viewing a person’s health condition from the patient’s point of view. This different perspective will help researchers or health practitioners to provide assistance and or therapy that is more appropriate to the patient’s mental and physical condition.

Application of Complementary and Alternative Medicine Therapy on Patient with Postoperative Pain After Cardiac Surgery: a Literature Review

Pain is a devastating outcome following cardiac surgery due to routine procedures, including chest tube removal, deep breathing, and coughing exercise. Pharmacological treatment requires complementary interventions in addressing the post-acute pain phase. This study aimed to identify the application of complementary and alternative medicine (CAM) to reduce postoperative pain after cardiac surgery. A literature search was conducted by exploring original studies on the Google Scholar, PubMed NCBI, ProQuest, and ScienceDirect database that published in the last five years (2016-2021), enrolled adult participants who were undergoing cardiac surgery, and evaluated the outcome of CAM therapy on the postoperative pain after the cardiac surgery. Eighteen original studies were analyzed and synthesized. Thirteen studies employed randomized controlled trial, four studies applied quasi-experimental, and one study used one group pre-post-test design. Among these studies, ten studies focused on the manipulative and body-based practices domain (cryotherapy and massage). The application of relaxation exercise, music therapy, and distraction technique from the mind-body intervention domain was discussed in six studies. Only three studies reported the utilization of therapy from the alternative medical system, biologically-based therapy, and energy therapy domain. The majority of the CAM interventions provided significant effects in postoperative pain relief after cardiac surgery. Nurses should be able to assign appropriate CAM therapies for each patient, although all domains of CAM consider as an effective modality for postoperative pain relief after cardiac surgery. Hence, the CAM therapy would be a proper complement for the pharmacological therapies, effective in reducing the pain, and provides a chance for the patient to manage their pain independently.

Knowledge, attitude, and practices of complementary and alternative medicine: a survey of physicians and nurses at an academic medical center in Beirut

ABSTRACT The aim of this study is to assess the knowledge, attitudes, and practices of complementary and alternative medicine (CAM) among physicians and nurses at the American University of Beirut Medical Center (AUBMC) in Beirut, Lebanon. A web-based survey was emailed to 518 physicians and 423 registered nurses in all medical departments at AUBMC. Of the 94 physicians responding to the survey, 61% have never referred a patient to a CAM practitioner yet 33% reported that they would refer if available. Sixty-two percent of physicians believed that incorporating evidence-based CAM therapies will increase patient satisfaction and 66% thought that offering CAM would attract more patients. Of the 80 nurses who responded, 78.7% have never referred a patient to a CAM practitioner, yet half reported that they would likely refer if a CAM practitioner was available. Fifty-seven percent of nurses surveyed believed that offering CAM would attract more patients while 59% thought that it would increase patient satisfaction. Most nurses were uncomfortable counseling patients about CAM modalities. Favorable attitudes towards CAM were reflected by the physicians and nurses as signified by the above-average attitude means towards CAM (M = 4.01, SD = .16 and M = 3.25, SD = .59, respectively). The study findings demonstrate that despite the physicians’ and nurses’ limited knowledge and their discomfort in counseling on CAM, they expressed acceptability and willingness in using and incorporating CAM therapies into clinical practice at AUBMC. This is the first study conducted in Lebanon that assesses both nurses’ and physicians’ perspectives on the use of all CAM domains in general within the same healthcare setting. This study not only provides baseline data but also highlights the knowledge gap and learning needs among physicians and nurses with regards to CAM.

Complementary and alternative system of medicine for type 2 diabetes mellitus and its complications: A scoping review

Background: This review aims to map the evidence on the effectiveness of Complementary and Alternative Medicine (CAM) for Type 2 Diabetes Mellitus (T2DM) and its associated complications and identify research gaps in key outcomes and CAMs. Methods: We followed the Johanna Briggs Institute guidelines to undertake this scoping review. We carried out a comprehensive search from inception to March 2020 in electronic databases and registers. Forward and backward citations of included studies were also searched. The randomized controlled trials (RCTs) and non-randomized studies with intervention and control arm were mapped based on the effectiveness of various CAM (Yoga, Ayurveda, Homeopathy, Siddha, Naturopathy, Unani, and Sowa-rigpa) on outcomes among individuals with prediabetes or metabolic syndrome, T2DM with and without any comorbidities. Results: A total of 249 studies were included after screening 3798 citations. Most of the included studies were conducted in India and Iran. Most frequently studied CAM interventions include Yoga, Ayurveda, and herbal products as compared to other CAM therapies. Conclusion: Although we identified a lot of literature on the effectiveness of CAMs for T2DM, there is a lack of standardization of preparation of these medicines and the interventional modalities. To validate the potential benefits of CAM, robust research with high-quality RCTs and systematic reviews are needed to bridge the gap of evidence in CAM therapies. Future investments for research in CAM may focus on assessing the quality of existing trials and finding out an optimal dose, frequency, and duration of CAM, both as an alternative and complementary approach.